There is a paucity of global data on cardiovascular disease (CVD) prevalence in people with type 2 diabetes (T2D). The primary objective of the CAPTURE study was to estimate the prevalence of ...established CVD and its management in adults with T2D across 13 countries from five continents. Additional objectives were to further characterize the study sample regarding demographics, clinical parameters and medication usage, with particular reference to blood glucose-lowering agents (GLAs: glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors) with demonstrated cardiovascular benefit in randomized intervention trials.
Data were collected from adults with T2D managed in primary or specialist care in Australia, China, Japan, Czech Republic, France, Hungary, Italy, Argentina, Brazil, Mexico, Israel, Kingdom of Saudi Arabia, and Turkey in 2019, using standardized methodology. CVD prevalence, weighted by diabetes prevalence in each country, was estimated for the overall CAPTURE sample and participating countries. Country-specific odds ratios for CVD prevalence were further adjusted for relevant demographic and clinical parameters.
The overall CAPTURE sample included 9823 adults with T2D (n = 4502 from primary care; n = 5321 from specialist care). The overall CAPTURE sample had median (interquartile range) diabetes duration 10.7 years (5.6-17.9 years) and glycated hemoglobin 7.3% (6.6-8.4%) 56 mmol/mol (49-68 mmol/mol). Overall weighted CVD and atherosclerotic CVD prevalence estimates were 34.8% (95% confidence interval CI 32.7-36.8) and 31.8% (95% CI 29.7-33.8%), respectively. Age, gender, and clinical parameters accounted for some of the between-country variation in CVD prevalence. GLAs with demonstrated cardiovascular benefit were used by 21.9% of participants, which was similar in participants with and without CVD: 21.5% and 22.2%, respectively.
In 2019, approximately one in three adults with T2D in CAPTURE had diagnosed CVD. The low use of GLAs with demonstrated cardiovascular benefit even in participants with established CVD suggested that most were not managed according to contemporary diabetes and cardiology guidelines. Study registration NCT03786406 (registered on December 20, 2018), NCT03811288 (registered on January 18, 2019).
Objective: The CAPTURE study found that the prevalence of CVD in adults with T2D is approximately 1 in 3. This post hoc analysis determined the association between CVD risk factors (RF) and CVD. ...Methods: CAPTURE was a cross-sectional, non-interventional study in people with T2D across 13 countries. Participant data were collected during a single routine clinical visit in a primary or specialist settings between Dec 1, 2018 and Sep, 2019. A multivariable logistic regression model was used to calculate prevalence odds ratios (PORs). Results: Data were from 6369 participants with the information available for all included variables from the total CAPTURE population (N=9823). Age and CKD (assessed by eGFR) were positively associated with CVD status (both p<0.0001). Other RF with high CVD PORs were: diagnosed hypertension (1.87), smoking (1.53), male sex (1.29), diabetes-related variables, HbA1c (1.07) and diabetes duration (1.01). Serum LDL-C and HDL-C had a negative association with CVD (both p <0.0001, Table). Conclusion: The high CVD prevalence in the CAPTURE study is associated with demographics, classic CVD RF and diabetes-related variables, especially CKD. A negative association with LDL-C reflect confounding through indication for the use of lipid-lowering agents. These data support the use of antidiabetes drugs with proven CV benefit on several CV RFs in people with T2D and CVD.
Objective: This CAPTURE post-hoc analysis identified patterns in the use of selected glucose-lowering agents (GLA) in people with T2D with or without CVD and by CVD risk factor prevalence. Methods: ...CAPTURE was a cross-sectional, observational study in people with T2D across 13 countries. Participant information was collected during a single routine clinical visit in a primary/specialist setting between Dec 1, 2018 and Sep 31, 2019. Data were analyzed descriptively. Results: Of 9823 participants, 3582 had a history of CVD (CVD group) and 6241 had no history of CVD (NoCVD group). Regardless of CVD status, use of GLA was more common in those who were males, aged 55-≤75 yrs, or who had a diabetes duration >10 yrs, HbA1c >7-<9%, diagnosed hypertension or an eGFR >60 ml/min/1.73m2. Newer agents (GLP-1 RAs and SGLT2is) were less prescribed versus insulins and sulfonylureas (SUs). Compared with NoCVD, use of newer agents was lower in people from CVD group who were aged <55 yrs or who were diagnosed with diabetes 10 yrs ago (Table). Conclusion: Insulins and SUs were more frequently used than newer GLA, regardless of CVD status. The low use of newer agents, particularly in younger people with short diabetes duration, suggests delayed introduction despite recent guidelines for managing people with T2D and CVD or CV risk.
Diabetes mellitus is currently a serious public health problem worldwide, that increases the risk of presenting microvascular and macrovascular complications. Although achieving the recommended blood ...glucose goals reduces the risk of microvascular complications, the effect of the drugs used to treat hyperglycemia on macrovascular complications and cardiovascular death is a cause for concern. In this context, the regulatory agencies have modified the regulations for the approval of new drugs in diabetes, by adding the need to demonstrate that they are capable of lowering blood glucose levels together with a solid assessment of cardiovascular safety. The objective of this study is to review the cardiovascular effects of the new families of non-insulin drugs, with special emphasis on their effect on the risk of major cardiovascular events. In recent years, it has finally been confirmed that some of the drugs used to treat diabetes are not only safe from a cardiovascular point of view, but have even shown capacity to reduce the risk of cardiovascular disease in type 2 diabetes mellitus. The evidence obtained determined the updating of some current therapeutic guidelines when cardiovascular risk should be considered a fundamental variable at the time of therapeutic choice in patients with diabetes.
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